AUTISM. What is it? How does it affect a student s learning? What do we do about it? Patricia Collins MS CCC-SLP

Transcription

1 AUTISM What is it? How does it affect a student s learning? What do we do about it? Patricia Collins MS CCC-SLP

2 Autism spectrum disorder is a neurodevelopmental disorder characterized by deficits in social communication and social interaction and the presence of restricted, repetitive behaviors. Restricted repetitive behaviors, interests, or activities are manifested by stereotyped, repetitive speech, motor movement, or use of objects, inflexible adherence to routines, restricted interests and hyper and/or hyposensitivity to sensory input. WHAT IS AUTISM?

3 The Diagnostic and Statistical Manual of Mental Disorders- 5 th edition (DSM-V) sets the criteria for diagnosis. Changes to the criteria have been made from DSM-IV to DSM-V Elimination of the following categories: PDD and PDD-NOS Asperger s Disorder Childhood Disintegrative Disorder Rett s Disorder WHAT IS AUTISM?

4 ASD prevalence remains at 1 in 68 children 1 in 54 in males, 1 in 252 in females Based on CDC study in 2014 Prevalence among non-hispanic white children was significantly greater than among non-hispanic black children and Hispanic children Suspected disparities may be influenced by under-identification among Hispanic and non-hispanic black children WHAT IS AUTISM?

5 Autism is heterogenous Individuals have abilities ranging from significant cognitive language impairments (non-verbal) to superior cognitive and language abilities. Core features of autism remain to be Impairments in social communication, language, and related cognitive skills, behavioral and emotional regulation. Presence of restricted, repetitive behaviors WHAT IS AUTISM?

6 Let s define social communication! Social reciprocity: initiating and responding to bids for interaction, turn-taking, contingent responses Social cognition: mental processes involved in perceiving, attending to, remembering, thinking about, and making sense of the people in our social world (perspective taking/narrative writing) WHAT IS AUTISM?

7 ASD research continues but three factors are believed to be part of the cause: Genetic risk factors Neurobiological factors Environmental factors WHAT IS AUTISM?

8 Genetic factors: Higher incidence of autism in children with siblings on the spectrum Higher incidence among identical twins than with fraternal twins WHAT IS AUTISM

9 WHAT IS AUTISM? Abnormalities in the genetic code may result in abnormal mechanisms for brain development in the frontal and anterior temporal lobes, caudate, and cerebellum

10 People with ASD may also have structural and functional abnormalities of the brain including: Increased gray matter in the frontal and temporal lobes Decreased white matter compared with gray matter by adolescence WHAT IS AUTISM?

11 People with ASD also may have differences in their brain s response to the environment Preference for nonsocial versus social processing Disruptions in normative patterns of social neurodevelopment that contributes to diminished attention to social stimuli WHAT IS AUTISM?

12 Environmental factors: It s complicated Research must include how the environmental factors interact with individual genetic information WHAT IS AUTISM?

13 Unable to engage socially in the school environment in a typical, expectable and acceptable way that may impair or hinder engagement in academics (JG, DR, RM) Difficulty with theory of mind/perspective taking which in turns impacts reading comprehension and written expression Difficulty with integrating diverse information to construct meaning in context (e.g. central coherence) Main idea Science concepts/history lessons and so much more. HOW DOES IT AFFECT A STUDENT S LEARNING?

14 When a person with ASD also has a language learning disability (involving any of the four language areas A/C, V/E, R/C, W/E) difficulty in school is increased even more Language disorders can present with the impaired acquisition of words, word combinations, and syntax, nonverbal and verbal communication, prosody, conversational skills, literacy skills, executive functioning skills. HOW DOES IT AFFECT A STUDENT S LEARNING

15 Behavioral and emotional regulation deficits can impact students, peers, and teachers greatly during their school day! Problems dealing with changes in routine (substitute teacher, classroom transitions) Generalizing learned skills Crying, becoming angry, laughing for no known reason or at inappropriate times Anxiety or social withdrawal (possibly due to factors such as misinterpretation of social events and failure to identify salient or irrelevant information) Scripted language And you could all make this list go on and on if you were to describe your own experiences! HOW DOES IT AFFECT A STUDENT S LEARNING?

16 Our FAPE is to provide the least restrictive environment and a free and appropriate public education according to MA regulations. Teachers, Administrators, SLP s, Special educators, Mental health adjustment counselors, Psychs, and anyone available in the building are all in it together. (RW/caf) WHAT DO WE DO ABOUT IT?

17 Speech and Language Pathologist s role: Screen, assess, diagnose, and treat persons with ASD ASHA includes clinical/educational services, prevention and advocacy, education, administration, and research Including assessing for the need for AAC devices Partnering with families in assessment and intervention Remaining informed of research in the area of ASD Specifically trained in the particular area (AAC) due to the great heterogeneity in the ASD population evidenced by the broad range of cognitive, social, communication, and adaptive abilities. WHAT CAN WE DO ABOUT IT?

18 The goal of intervention is to improve social communication and other language impairments and modify behaviors to improve an individual s access to the curriculum. Essential outcomes focus on improvements in social communication that affect the individual s ability to develop relationships, function effectively, and actively participate in the school setting. WHAT CAN WE DO ABOUT IT?

19 Interventions: Multimodal communication system- spoken language, gestures, sign language, picture communication, Speech-generating devices, written language Family involvement, priorities Range of approaches En vivo Peer modeling (HMS PE) Video modeling Explicit teaching WHAT CAN WE DO ABOUT IT?

20 a list of more interventions: ABA (Applied Behavioral Analysis) utilizes principles of learning theory to bring about meaningful and positive change in behavior Discrete trial training- one to one instructional approach utilizing behavioral methods to teach skills in small, incremental steps in a systematic, controlled fashion. Functional Communication training problem behaviors are eliminated through extinction and replaced with alternate, more appropriate forms of communicating needs or wants. Incidental teaching (utilizes natural teaching opportunities in the classroom) Milieu therapy a range of methods (including incidental teaching) that are included in the everyday environments and not just during therapy time WHAT CAN WE DO ABOUT IT?

21 Interventions Continued: Cognitive Behavioral Therapy (CBT) Combines cognitive and behavioral principles to shape and encourage desired behaviors; assumes individual s behavior is mediated by maladaptive patterns of thought and attempts to change thinking or cognitive patterns. WHAT CAN WE DO ABOUT IT?

22 More! Literacy intervention: incorporate a variety of instructional strategies to improve word decoding, word id, reading fluency, vocabulary, explicit instruction in narrative perspective taking, RRR (read, recite, review), shared book reading, reading and writing about personal experiences. Parent-mediated/implemented intervention More than words, Talkability, Son-Rise all apps that encourage parental intervention to improve their child s social communication WHAT CAN WE DO ABOUT IT?

23 And guess what? Even more. SCERTS- social communication emotional regulation and transactional support is a comprehensive framework for targeting critical intervention goals elevant to the individual s stage of social and emotional, and communication development. Social scripts Social skills groups And even more (TEACCH, floortime, Relationship development Intervention) WHAT CAN WE DO ABOUT IT?

24 In the classroom, we can: Understand the causes of autism and the child s specific deficits Utilize the SLP and special educators to assist you in the classroom Autism presents itself in many ways and sometimes it looks apathetic The student may need sensory stimulation, may not understand a global concept in the classroom (e.g. we need to form groups to discuss the topic and then complete a task together to receive a grade), needs encouragement cues to stay on task when attention has waned or understanding is not complete. WHAT CAN WE DO ABOUT IT?

25 Utilize their peers whenever appropriate! This can be a tricky one to navigate but we know a good setup when we see it! WHAT CAN WE DO ABOUT IT?

26 American Speech-Language Hearing Association American Academy of Pediatric s Autism Resources Austism Intervention Research Network on Behavioral Health (AIR-B) Autism Navigator Autism Now Autism Speaks Bilingual Autism Guide Birth to 5: Watch me Thrive Center on Secondary Education for Students with Autism Spectrum Disorder RESOURCES

27 CDC: Learn the Signs Easter Seals: Autism Services Evidence Based Practices for Chilren, Youth, and Young Adults with ASD National Autism Association Strategic Plan for Autism Spectrum Disorder Research The Autism Genome Project Consortium The Center on Secondary Education for Students with ASD What Works Clearinghouse RESOURCES, CONTINUED

28 Adams, C., Lockton, E., Freed, J., Gaile, J., Earl, G., McBean, K.,... Law, J. (2012). The Social Communication Intervention Project: A randomized controlled trial of the effectiveness of speech and language therapy for school-age children who have pragmatic and social communication problems with or without autism spectrum disorder. International Journal of Language and Communication Disorders, 47(3), American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5 th ed.). Washington, DC. American Speech-Language-Hearing Association. (2007). Scope of practice in speech-language pathology[scope of Practice]. Available from American Speech-Language-Hearing Association. (2010). Code of ethics [Ethics]. Available from REFERENCES

29 Autism Task Force. (2003). Service guidelines for individuals with autism spectrum disorder/pervasive developmental disorder (ASD/PDD): Birth through twenty-one. Ohio: Ohio Developmental Disabilities Council. Delano, M. E. (2007). Video modeling interventions for individuals with autism. Remedial and Special Education, 28(1), Interagency Autism Coordinating Committee (IACC). IACC strategic plan for autism spectrum disorder (ASD) research 2012 update. (2012). Retrieved from the U.S. Department of Health and Human Services Interagency Autism Coordinating Committee website: REFERENCES

30 Quiz time! THANK YOU FOR ATTENDING THIS SESSION!